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https://www.readbyqxmd.com/read/28093812/factors-predicting-incidence-of-post-operative-delirium-in-older-people-following-hip-fracture-surgery-a-systematic-review-and-meta-analysis
#1
REVIEW
T O Smith, A Cooper, G Peryer, R Griffiths, C Fox, J Cross
OBJECTIVE: Delirium is one of the most common complications following hip fracture surgery in older people. This study identified pre- and peri-operative factors associated with the development of post-operative delirium following hip fracture surgery. METHODS: Published and unpublished literature were searched to identify all evidence reporting variables on patient characteristics, on-admission, intra-operative and post-operative management assessing incident delirium in older people following hip fracture surgery...
January 17, 2017: International Journal of Geriatric Psychiatry
https://www.readbyqxmd.com/read/28092990/in-hospital-statin-underutilization-among-high-risk-patients-delayed-uptake-of-the-2013-cholesterol-guidelines-in-a-u-s-cohort
#2
Subeer K Wadia, Mark Belkin, Kelsey Chow, Jonathan Nattiv, Andrew Appis, Steven B Feinstein, Kim Allan Williams
OBJECTIVES: Clinician utilization of the 2013 cholesterol lowering guidelines remains variable and unknown. We sought to examine statin prescribing patterns and compare rates among specialists who treat high-risk cardiovascular patients admitted to the hospital. METHODS: We retrospectively (via chart review) examined four specialty groups: (i) Cardiology, (ii) Cardiovascular or Vascular (CV) Surgery, (iii) Neurology, and (iv) Internal Medicine. Adult patients were included based on a discharge diagnosis of acute coronary syndrome, coronary artery bypass graft surgery, carotid endarterectomy, acute ischemic stroke, transient ischemic attack, or high-risk chest pain...
January 17, 2017: Hospital Practice (Minneapolis)
https://www.readbyqxmd.com/read/28077453/state-regulatory-approaches-for-dementia-care-in-residential-care-and-assisted-living
#3
Paula C Carder
PURPOSE: This policy study analyzed states' residential care and assisted living (RC/AL) regulations for dementia care requirements. Estimates suggest that at least half of RC/AL residents have dementia, and 22% of settings provide or specialize in dementia care. Residents with dementia might benefit from regulations that account for specific behaviors and needs associated with dementia, making states' RC/AL regulations address dementia care an important policy topic. DESIGN AND METHODS: This study examined RC/AL regulations in all 50 states and the District of Columbia for regulatory requirements on five topics important to the quality of life of RC/AL residents with dementia: pre-admission assessment, consumer disclosure, staffing types and levels, administrator training, and physical environment...
January 10, 2017: Gerontologist
https://www.readbyqxmd.com/read/27965823/feasibility-of-a-stepped-wedge-cluster-rct-and-concurrent-observational-sub-study-to-evaluate-the-effects-of-modified-ward-night-lighting-on-inpatient-fall-rates-and-sleep-quality-a-protocol-for-a-pilot-trial
#4
Satyan R Chari, Simon Smith, Alison Mudge, Alex A Black, Mariana Figueiro, Muhtashimuddin Ahmed, Mark Devitt, Terry P Haines
BACKGROUND: Falls among hospitalised patients impose a considerable burden on health systems globally and prevention is a priority. Some patient-level interventions have been effective in reducing falls, but others have not. An alternative and promising approach to reducing inpatient falls is through the modification of the hospital physical environment and the night lighting of hospital wards is a leading candidate for investigation. In this pilot trial, we will determine the feasibility of conducting a main trial to evaluate the effects of modified night lighting on inpatient ward level fall rates...
2016: Pilot and Feasibility Studies
https://www.readbyqxmd.com/read/27943349/problems-with-continuity-of-care-identified-by-community-pharmacists-post-discharge
#5
H T Ensing, E S Koster, P I van Berkel, A A van Dooren, M L Bouvy
WHAT IS KNOWN AND OBJECTIVE: Medication discrepancies are common at hospital discharge, and medication reconciliation is widely endorsed as a preventive strategy. However, implementation is difficult for instance due to the unreliability of patients medication histories. In the Netherlands, community pharmacies are well-informed about their patients' pre-admission medication status which enables thorough post-discharge reconciliation. Our aim was to study the frequency and nature of medication discrepancies, missing patient's knowledge and administrative problems at admission to primary care...
December 10, 2016: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/27935649/intense-pre-admission-carriage-and-further-acquisition-of-esbl-producing-enterobacteriaceae-among-patients-and-their-caregivers-in-a-tertiary-hospital-in-rwanda
#6
Mathis S E Kurz, Claude Bayingana, Jules M Ndoli, Augustin Sendegeya, Anita Durst, Roland Pfüller, Jean Bosco Gahutu, Frank P Mockenhaupt
OBJECTIVES: To assess the presence and risk factors of intestinal carriage extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-PE) among patients admitted to the University Teaching Hospital of Butare and among their attending caregivers; and to analyse the acquisition of ESBL-PE carriage during hospital stay and associated factors. METHODS: We screened 392 patients and their attending caregivers at admission and discharge for ESBL-PE carriage. Bacterial species were determined using the API-20E system, and antimicrobial susceptibility testing was done by agar disc-diffusion...
December 9, 2016: Tropical Medicine & International Health: TM & IH
https://www.readbyqxmd.com/read/27900737/three-year-mortality-in-30-day-survivors-of-critical-care-with-acute-kidney-injury-data-from-the-prospective-observational-finnaki-study
#7
Henriikka Mildh, Ville Pettilä, Anna-Maija Korhonen, Sari Karlsson, Tero Ala-Kokko, Matti Reinikainen, Suvi T Vaara
BACKGROUND: The role of an episode of acute kidney injury (AKI) in long-term mortality among initial survivors of critical illness is controversial. We aimed to determine whether AKI is independently associated with decreased survival at 3 years among 30-day survivors of intensive care. RESULTS: We included 2336 30-day survivors of intensive care enrolled in the FINNAKI study conducted in seventeen medical-surgical ICUs in Finland during a 5-month period in 2011-2012...
December 2016: Annals of Intensive Care
https://www.readbyqxmd.com/read/27863876/scoping-review-the-use-of-early-warning-systems-for-the-identification-of-in-hospital-patients-at-risk-of-deterioration
#8
REVIEW
Marie Danielle Le Lagadec, Trudy Dwyer
INTRODUCTION: Early warning systems (EWS) were developed as a means of alerting medical staff to patient clinical decline. Since 85% of severe adverse events are preceded by abnormal physiological signs, the patient bed-side vital signs observation chart has emerged as an EWS tool to help staff identify and quantify deteriorating patients. There are three broad categories of patient observation chart EWS: single or multiple parameter systems; aggregated weighted scoring systems; or combinations of single or multiple parameter and aggregated weighted scoring systems...
November 15, 2016: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
https://www.readbyqxmd.com/read/27817882/does-early-beta-blockade-in-isolated-severe-traumatic-brain-injury-reduce-the-risk-of-post-traumatic-depression
#9
Rebecka Ahl, Gabriel Sjolin, Shahin Mohseni
INTRODUCTION: Depressive symptoms occur in approximately half of trauma patients, negatively impacting on functional outcome and quality of life following severe head injury. Pontine noradrenaline has been shown to increase upon trauma and associated β-adrenergic receptor activation appears to consolidate memory formation of traumatic events. Blocking adrenergic activity reduces physiological stress responses during recall of traumatic memories and impairs memory, implying a potential therapeutic role of β-blockers...
January 2017: Injury
https://www.readbyqxmd.com/read/27787771/patterns-of-drug-use-and-serum-sodium-concentrations-in-older-hospitalized-patients-a-latent-class-analysis-approach
#10
Richard J Woodman, Karen M Wood, Aline Kunnel, Maneesha Dedigama, Matthew A Pegoli, Roy L Soiza, Arduino A Mangoni
BACKGROUND: Several drugs may lower serum sodium concentrations (NaC) in older patients. However, distinguishing their individual effects is particularly difficult in this population because of the high prevalence of polypharmacy and disease states that are per se associated with hyponatremia. OBJECTIVES: Our objective was to identify specific patterns of medication use in older hospitalized patients and determine whether these patterns were associated with serum NaC...
December 2016: Drugs—Real World Outcomes
https://www.readbyqxmd.com/read/27748206/prognostic-effect-of-pre-and-post-admission-antibiotic-treatment-in-paediatric-acute-mastoiditis
#11
E Carmel, J H Curotta, A T Cheng
OBJECTIVE: To evaluate the effect of pre- and post-admission antibiotic treatment in paediatric acute mastoiditis. DESIGN: Retrospective study. METHOD: Eighty-eight children with acute mastoiditis, from 2003 to 2012, were studied to investigate the effect of antibiotic therapy on short and long-term sequelae. RESULTS: The median period of antibiotic therapy immediately following hospital discharge was 10 days (range, 5-49 days; standard deviation = 7...
October 17, 2016: Journal of Laryngology and Otology
https://www.readbyqxmd.com/read/27744415/examining-the-importance-of-admissions-criteria-in-predicting-nursing-program-success
#12
Oscar Wambuguh, Monika Eckfield, Lynn Van Hofwegen
Baccalaureate nursing programs select students likely to graduate, become licensed, and contribute to a diverse workforce, and admissions criteria need to support those goals. This study assessed five criteria: pre-admit science GPA; TEAS score; healthcare experience; previous baccalaureate degree; and pre-admission university enrollment vs. college transfer as predictors of three desired outcomes: graduation; nursing program GPA; and passing NCLEX-RN. Results found TEAS and pre-admit science GPA predicted nursing program outcomes...
September 20, 2016: International Journal of Nursing Education Scholarship
https://www.readbyqxmd.com/read/27622778/retrospectively-patient-reported-pre-event-health-status-showed-strong-association-and-agreement-with-contemporaneous-reports
#13
REVIEW
Esther Kwong, Nick Black
OBJECTIVE: The unpredictability of the occurrence of illnesses and injuries leading to most emergency admissions to hospital makes it impossible prospectively to collect pre-admission patient reported outcome measures (PROMs). Our aims were to review the evidence for using retrospective PROMs to determine pre-event health status and the validity of using general population norms instead of retrospective PROMs. STUDY DESIGN AND SETTING: Searches of Medline, PsycINFO, Embase, Global Health, and Health Management information...
September 10, 2016: Journal of Clinical Epidemiology
https://www.readbyqxmd.com/read/27616965/early-discharge-planning-and-improved-care-transitions-pre-admission-assessment-for-readmission-risk-in-an-elective-orthopedic-and-cardiovascular-surgical-population
#14
Brenda Ohta, Ana Mola, Peri Rosenfeld, Shauna Ford
BACKGROUND/METHODS: Readmission prevention is a marker of patient care quality and requires comprehensive, early discharge planning for safe hospital transitions. Effectively performed, this process supports patient satisfaction, efficient resource utilization, and care integration. This study developed/tested the utility of a predictive early discharge risk assessment with 366 elective orthopedic/cardiovascular surgery patients. Quality improvement cycles were undertaken for the design and to inform analytic plan...
2016: International Journal of Integrated Care
https://www.readbyqxmd.com/read/27608340/use-of-the-montreal-cognitive-assessment-test-to-investigate-the-prevalence-of-mild-cognitive-impairment-in-the-elderly-elective-surgical-population
#15
N A Smith, Y Y Yeow
Postoperative cognitive disorders are common in elderly patients. Pre-existing cognitive impairment including mild cognitive impairment may be an important risk factor for developing postoperative cognitive dysfunction and may not be detected in a standard preoperative interview, yet is not routinely sought. Our primary aim was to estimate the prevalence of mild cognitive impairment among elderly patients presenting to our hospital for elective surgery using a simple established screening tool: the Montreal Cognitive Assessment test...
September 2016: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/27596721/clinical-frailty-adds-to-acute-illness-severity-in-predicting-mortality-in-hospitalized-older-adults-an-observational-study
#16
Roman Romero-Ortuno, Stephen Wallis, Richard Biram, Victoria Keevil
AIM: Frail individuals may be at higher risk of death from a given acute illness severity (AIS), but this relationship has not been studied in an English National Health Service (NHS) acute hospital setting. METHODS: This was a retrospective observational study in a large university NHS hospital in England. We analyzed all first non-elective inpatient episodes of people aged ≥75years (all specialties) between October 2014 and October 2015. Pre-admission frailty was assessed with the Clinical Frailty Scale (CFS) of the Canadian Study on Health & Aging, and AIS in the Emergency Department was measured with a Modified Early Warning Score (ED-MEWS<4 was considered as low acuity, and ED-MEWS≥4 as high acuity)...
November 2016: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/27595266/the-effect-of-age-on-characteristics-and-mortality-of-intracerebral-hemorrhage-in-the-oldest-old
#17
Paola Forti, Fabiola Maioli, Michele Domenico Spampinato, Carlotta Barbara, Valeria Nativio, Maura Coveri, Marco Zoli, Luigi Simonetti, Giuseppe Di Pasquale, Gaetano Procaccianti
BACKGROUND: Incidence of acute intracerebral hemorrhage (ICH) increases with age, but there is a lack of information about ICH characteristics in the oldest-old (age ≥85 years). In particular, there is a need for information about hematoma volume, which is included in most clinical scales for prediction of mortality in ICH patients. Many of these scales also assume that, independent of ICH characteristics, the oldest-old have a higher mortality than younger elderly patients (age 65-74 years)...
2016: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/27558355/prevalence-and-risk-factors-for-medication-reconciliation-errors-during-hospital-admission-in-elderly-patients
#18
Blanca Rodríguez Vargas, Eva Delgado Silveira, Irene Iglesias Peinado, Teresa Bermejo Vicedo
Background Care transitions are risk points for medication discrepancies, especially in the elderly. Objective This study was undertaken to assess prevalence and describe medication reconciliation errors during admission in elderly patients and to analyze associated risk factors. We also evaluate the effect of these errors on the length of hospital stay. Setting General surgery, orthopedics, internal medicines and infectious diseases departments of a 1070-bed Spanish teaching hospital. Method This is a prospective observational study...
October 2016: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/27553636/psychiatric-history-post-discharge-distress-and-personality-characteristics-among-incident-female-cases-of-takotsubo-cardiomyopathy-a-case-control-study
#19
Elena Salmoirago-Blotcher, Lindsey Rosman, Ilan S Wittstein, Shira Dunsiger, Heather H Swales, Gerard P Aurigemma, Ira S Ockene
BACKGROUND: The role of psychological factors in the onset of takotsubo cardiomyopathy (TC) is still controversial. Associations with previous psychiatric conditions are registry-based; associations with personality characteristics and psychological sequelae of TC have been largely unexplored. This case-control study sought to study pre-admission psychiatric morbidity, personality traits, and post-discharge distress in incident cases of TC. METHODS: TC cases (Mayo clinic criteria) and acute myocardial infarction (MI) controls were recruited among women admitted to two Emergency Departments in New England...
August 20, 2016: Heart & Lung: the Journal of Critical Care
https://www.readbyqxmd.com/read/27505067/neutrophil-gelatinase-associated-lipocalin-as-a-diagnostic-marker-for-acute-kidney-injury-in-oliguric-critically-ill-patients-a-post-hoc-analysis
#20
Mohamud Egal, Hilde R H de Geus, A B Johan Groeneveld
BACKGROUND: Oliguria occurs frequently in critically ill patients, challenging clinicians to distinguish functional adaptation from serum-creatinine-defined acute kidney injury (AKIsCr). We investigated neutrophil gelatinase-associated lipocalin (NGAL)'s ability to differentiate between these 2 conditions. METHODS: This is a post-hoc analysis of a prospective cohort of adult critically ill patients. Patients without oliguria within the first 6 h of admission were excluded...
2016: Nephron
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